Endoscopic sinus surgery or Caldwell-Luc operation in the treatment of chronic and recurrent maxillary sinusitis.

The treatment of chronic and recurrent maxillary sinusitis has been changed in recent years. The radical Caldwell-Luc approach has increasingly been replaced by more conservative functional endoscopic sinus surgery (FESS). In the central hospital of Central Finland between 1991 and 1992, 260 patients (424 sinuses) suffering from chronic or recurrent maxillary sinusitis were operated on. Patients were classed into three groups according to the patient history of sinusitis. The plain sinus films (occipitomental projections) were evaluated. Complication rate and the need for reoperations were evaluated retrospectively after a mean follow-up time of 3.8 years. Patients in the Caldwell-Luc group had more serious disease than in the FESS or antrostomy group. The plain sinus films taken preoperatively showed more opacification in maxillary sinuses in the Caldwell-Luc group than in the FESS or antrostomy group. Complication rate was 4.4% in the Caldwell-Luc group and 2.6% in the FESS group. No serious complications existed in the whole material. Patients treated with Caldwell-Luc operation in 1991 and 1992 needed reoperation in 7/96 cases (7.3%) and 3/63 cases (4.8%), respectively. In the FESS group, patients operated 1991 and 1992 needed reoperation in 3/11 cases (27%) and 13/72 cases (18%), respectively.